Background:Ventilator-associated pneumonia (VAP) is the most common intensive care unit acquired infection, and it is associated withincrease in hospitalization, health care cost and mortality. It classified into early onset or late onset. Objectives: measure the incidence rate and risk factors of VAP, measure the VAP impact on length of stay in ICU
and duration ofmechanical ventilation and to measure adherence to IHI (institute of health improvement) ventilator bundle. Methods: A prospective study conducted at surgery hospital ICUs.All ventilated patients who didn't developed chest infections after 48h of mechanical ventilation are followed until discharge from ICU. Results: 56.2% of the
study population wasmales; the mean age was 43.2+ 15.6. Incidence density was 38.3per 1000 ventilation day. Early onset VAP was 47.5% and late onset VAP was 52.5%. The independent risk factors of VAP infection are age ≥ 60 years, duration of mechanical ventilation, smoking, chest diseases, insertion of IV cannula and APACHE II score.Crude
mortality rate was 42.1%. VAP infection has a significant impact on both the length of stay in ICU and duration of mechanical ventilation.VAP cases have lower adherence to all IHI ventilator bundle elements and the overall compliance was 71± 22.8 in VAP cases versus 80.7±16.0 in non VAP. Gram negative MDRs bacteria were isolated in 84.3% of
VAP cases.The commonest isolated bacteria wasAcintobacter(33.9%).Conclusion:VAP is a serious ICU acquired infection with significant impact and required effective preventive action.